Individual provider Active NPI

Michelle Dominique Segretto, ,PT, DPT, COMT, CERT

  • Physical Therapist
  • New Orleans, LA
National Provider Identifier
1275965055
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011131 Issued in GA
Practice address
5300 Tchoupitoulas Street, Suite C1
New Orleans, LA 70115
Phone
(504) 703-3096
Fax
(504) 703-9101
NPI assigned
Aug 5, 2013
Last updated
Aug 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT011131 GA Primary

Addresses

Primary practice location

5300 Tchoupitoulas Street, Suite C1
New Orleans, LA 70115

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1275965055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 TCHOUPITOULAS STREET, SUITE C1",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70115",
            "telephone_number": "504-703-3096",
            "fax_number": "504-703-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGRETTO",
        "first_name": "MICHELLE",
        "middle_name": "DOMINIQUE",
        "credential": ",PT, DPT, COMT, CERT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-05",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.